Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,964.00 / $6,960.00 / $11,611.47	Facility		$4,964.00	$6,960.00	$11,611.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.98 / $1,686.43 / $3,069.81	Professional		$338.98	$1,686.43	$3,069.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $725.34 / $909.15 / $5,001.82	Professional		$725.34	$909.15	$5,001.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $443.50 / $2,255.15 / $3,930.09	Professional		$443.50	$2,255.15	$3,930.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $742.34 / $4,331.63 / $14,194.81	Facility		$742.34	$4,331.63	$14,194.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $917.99 / $4,331.63 / $7,411.33	Professional		$917.99	$4,331.63	$7,411.33
Midlands Facility/Professional Facility Modifier Low / Median / High Price $804.32 / $4,723.05 / $6,392.37	Facility		$804.32	$4,723.05	$6,392.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $742.34 / $3,580.34 / $5,423.27	Professional		$742.34	$3,580.34	$5,423.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $350.84 / $1,594.28 / $7,052.39	Professional		$350.84	$1,594.28	$7,052.39
United Facility/Professional Facility Modifier Low / Median / High Price $8,220.00 / $9,346.00 / $14,242.22	Facility		$8,220.00	$9,346.00	$14,242.22
United Facility/Professional Professional Modifier Low / Median / High Price $2,296.12 / $4,505.00 / $6,854.67	Professional		$2,296.12	$4,505.00	$6,854.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $680.60 / $800.70 / $4,021.60	Professional		$680.60	$800.70	$4,021.60